Thinking globally about latrine duty

The Big Necessity The Unmentionable World of Human Waste and Why It Matters; Rose George; Metropolitan Books: 288 pp., $26

ROSE GEORGE'S "The Big Necessity" should become a classic in the limited literary annals of coprology. George, who is British, is an ebullient descendant of the virtuous Victorians, including Thomas Crapper, who brought us modern plumbing.

With wit and style, she goes to sewage school, ventures into the sewers of London and New York, attends international toilet conferences and visits cities, villages, townships and slums in Africa, Europe, the United States, India, Japan and China.

Along the way, she shines a spotlight on unknown but charismatic leaders in South Africa, heroic campaigners in India and industrious Chinese reformers who have converted 15.4 million rural households to biogas digesters: a cheap and inexhaustible supply of clean energy.

She even reveals the wonders of Japanese "washlets" -- "a generic word for a high-function toilet" -- especially the warm toilet seat manufactured by Toto. With $4.2 billion in sales in 2006, Toto has entranced the Japanese.

So far, the Americans and English have resisted the charms of a toilet that can "check your blood pressure, play you music, wash and dry your bottom by means of an in-toilet nozzle, put the seat lid down for you, and flush away your excreta without requiring anything as old-fashioned as a tank."

Unfortunately, there are few toilets available in India, Africa, South Africa, Malaysia or Bangladesh.

It is in these countries that George discovers the omnipresent and dangerous results of limited or nonexistent access to sanitation.

Although the Chinese have long used human waste -- night soil -- as fertilizer, other nations often let their waste lie in the open, contaminating water and food.

This is especially true in India, where "nearly 800 million Indians" resist pressure to change historic habits of open defecation in fields, at roadsides and beside train tracks. Sanitation is a hard sell in that nation, as millions of government-built latrines have been turned into firewood stores or goat sheds.

From his headquarters in Mumbai, Dr. Bandeshwar Pathak has struggled for decades to persuade Indians to abandon centuries of tradition. Endowed with a "messianic" fervor, he has designed a new toilet called Easy Latrine. Despite its relatively inexpensive cost, however, the technology has found few converts.

Pathak has built the world's first known toilet museum and invented the one-cup water flush toilet, but he admits that changing habits is difficult.

For more than 30 years, Joe Madiath has been on his own campaign to develop a "toileted lifestyle" in India -- also with limited success. His nonprofit project, Gram Vikas, which is based in the Indian state of Orissa, has won major international awards. Yet of the 50,000 villages in Orissa, only 361 have total sanitation.

While India continues to defeat the best efforts of reformers, activists in other countries have had more success. In Bangladesh, agricultural scientist Kamal Kar has successfully enlisted villagers to adopt the Community-Led Total Sanitation program, or CLTS.

CLTS enlists villagers in local campaigns to shock and embarrass neighbors when they see flies transporting contamination from feces to food. Disgust leads to shame, which then leads to pride as villagers build homegrown latrines and put up posters: "No-one defecates in the open in this village."

The United Nations declared 2008 the Year of Sanitation. But human waste, excreta, is a subject no one wants to talk about: 2.5 billion people worldwide are without basic sanitation. The toll among children is particularly devastating; 1.6 million die each year from diarrhea-related diseases, more than from malaria, tuberculosis or HIV.

Sanitation proselytizers such as Singapore businessman Jack Sim labor without recognition. The director of the World Toilet Organization, he designated Nov. 19 as World Toilet Day. This too is observed by the United Nations. But there have been no parades down Main Street for sanitation. No celebrities have signed up to publicize the crisis.

Despite her extensive research, George is on weak ground when she critiques the use of treated sewage sludge, also known as biosolids.

The United Nations Global Atlas of Waste Water Sludge Disposal and Biosolids Use released this month strongly defends the safety of the practice. The 632-page document covers more than 37 nations that have adopted extensive use of rigidly regulated biosolids for land application and co-composting.

George also dismisses water recycling as "toilet-to-tap," apparently unaware of recent advances in wastewater treatment and growing acceptance in drought-stricken areas such as Southern California.

Overall, however, "The Big Necessity" is a valuable and often entertaining, if somewhat dismal, account of the travails of human waste disposal.

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Anna Sklar is the author of "Brown Acres: An Intimate History of the Los Angeles Sewer System."